Strengthening research ethics governance and regulatory oversight in Central America and the Dominican Republic in response to the COVID-19 pandemic: a qualitative study.

BACKGROUND: Good governance and regulatory supervision are required to conduct research in an international public health emergency context and to ensure compliance with ethical standards. The "Strengthening research ethics governance and regulatory oversight in Central America and the Dominican Republic in response to the COVID-19 pandemic" study is a regional effort in which research ethics stakeholders participated in addressing research ethics governance and preparedness response challenges to the COVID-19 pandemic in Central America and the Dominican Republic. METHODS: A qualitative action research study was conducted following a participatory approach. Research ethics stakeholders in Central America and the Dominican Republic were mapped; a regional webinar and three virtual workshops were conducted discussing research ethics governance, ethics review and collaborative research practice during the pandemic. A roundtable session presented results and obtained feedback on a draft of a policy to strengthen regional research ethics governance. RESULTS: Countries across Central America and the Dominican Republic are at different stages in their development of research ethics systems. Countries with more established systems before COVID-19 were better organized and prepared to respond. This finding argues against improvisation and supports further work on strengthening governance of research ethics systems. Community engagement in research ethics public policy-making is practically absent in the region. Research and research ethics collaboration schemes are lacking amongst the countries; however, there are incipient initiatives in the region, such as the Central America and Caribbean Network of Research Ethics Committees. A policy brief with recommendations on how to advance towards strengthening the governance of research ethics systems was prepared and submitted to the Central American Integration System for analysis and possible approval. CONCLUSION: National research ethics systems in Central America and the Dominican Republic were unprepared to respond to the COVID-19 pandemic with respect to research oversight and effective collaboration. In most cases, national research ethics systems were found to be weak, and regional research collaboration was practically absent. To promote collaboration, a joint strategy needs to be developed with a regional vision towards sharing knowledge and best practices.

Prevalence of adverse childhood experiences (ACEs) and association with dating violence and symptoms of mental illness among adolescents in the Dominican Republic.

BACKGROUND: Adolescent dating violence (ADV) and mental illness are highly prevalent, interrelated public health priorities. Increasingly, scholars are looking to adverse childhood experiences (ACEs) to explain risk for these health concerns. OBJECTIVES: Determine prevalence of ACEs, ADV perpetration and victimization, and anxiety and depression symptoms among adolescents in the Dominican Republic (DR). Evaluate the association of ACEs with these ADV and mental health outcomes. PARTICIPANTS AND SETTING: Cross-sectional survey data were collected from 142 adolescents at middle and high schools in the DR. METHODS: We assessed ACEs using the Childhood Experiences Survey, ADV using the Conflict in Dating Relationships Inventory, and depression/anxiety symptoms using Patient-Reported Outcomes Measurement Information System scales. Linear and logistic regressions were performed to test dose-response relationships between a cumulative ACE score and ADV and mental health outcomes while adjusting for age, gender, and rural/urban residence. RESULTS: 80.6% of students reported at least one ACE. The most prevalent ACEs reported were physical abuse (49%) and witnessing domestic violence (48%). After adjusting for covariates, cumulative ACE scores were significantly associated with depression symptoms, anxiety symptoms, physical and emotional ADV perpetration, and physical and emotional ADV victimization. CONCLUSIONS: Structural and community-based interventions to prevent ADV and promote mental health for adolescents in the DR should address ACEs.

Psychological helpline in response to the COVID-19 pandemic in the Dominican Republic.

The global health emergency due to COVID-19 is a disruptive event that has had various effects on mental health. Given this emergency, the Dominican Republic intervened to mitigate the negative impact of the pandemic, considering the physical isolation decreed in the country. In this context, the Autonomous University of Santo Domingo and the School of Psychology designed the UASD COVID-19 Psychological Helpline. The objective of this article is to describe the development, implementation and evaluation of a programme of psychological first aid. The programme aimed to attenuate the impact of morbidity and mortality due to mental health issues associated with the COVID-19 pandemic through mobile technology. There were 62 psychologists involved and trained to provide care, and a protocol was developed, implemented, monitored and evaluated. Over the course of four months, the programme assisted 497 people. The average age of the participants was 32 years, and 73% were women. The reasons for contacting the helpline included anxiety, stress, depression, domestic violence, suicidal behaviours and other behavioural problems. Following the intervention, most users reported feeling satisfied and having improved emotions. The first psychological aid in the country developed through telephone and chat messaging was an optimal resource since face-to-face interaction was not possible. It also reached more people and reduced the attention gap.

Ethical challenges for international collaborative research partnerships in the context of the Zika outbreak in the Dominican Republic: a qualitative case study.

BACKGROUND: The establishment of international collaborative research partnerships in times of infectious disease outbreaks of international importance has been considered an ethical imperative. Frail health research systems in low- and middle-income countries can be an obstacle to achieve the goal of knowledge generation and the search for health equity before, during and after infectious disease outbreaks. METHODS: A qualitative case study was conducted to identify the challenges and opportunities facing the Dominican Republic with regards to developing international collaborative research partnerships in the context of the Zika outbreak and its ethical implications. Researchers conducted 34 interviews (n = 30 individual; n = 4 group) with 39 participants (n = 23 males; n = 16 females) representing the government, universities, international donor agencies, non-governmental organisations, community-based organisations and medical societies, in two metropolitan cities. RESULTS: Five international collaborative research projects related to the Zika virus were identified. Major ethical challenges were linked to the governance of health research, training of human resources, the institutionalisation of scientific activity, access to research funds and cultural aspects. Capacity-building was not necessarily a component of some partnership agreements. With few exceptions, local researchers were merely participating in data collection and less on defining the problem. Opportunities for collaborative work included the possibility of participation in international research consortiums through calls for proposals. CONCLUSIONS: The Dominican government and research stakeholders can contribute to the international response to the Zika virus through active participation in international collaborative research partnerships; however, public recognition of the need to embrace health research as part of public policy efforts is warranted. A working group led by the government and formed by national and international research stakeholders will be key to identify ways in which the country could respond to the ethical demand of generating new knowledge in times of outbreaks.

Comités de ética de investigación en República Dominicana: un análisis desde las pautas éticas internacionales para la investigación biomédica con seres humanos / Comitês de ética em pesquisa na República Dominicana: uma análise a partir das pautas éticas internacionais para a pesquisa biomédica com seres humanos / Scientific ethical review committees in Dominican Republic: an analysis based on international ethical guidelines for biomedical research involving human beings

El objetivo de este estudio es describir la situación de los comités de ética de investigación (CEI) de República Dominicana, en términos tanto de su organización, composición, actividades y necesidades de capacitación, como del nivel en que siguen las recomendaciones ofrecidas por las Pautas Éticas Internacionales para la Investigación Biomédica en Seres Humanos (2002). Se incluyeron los siete CEI que reportaron actividades durante 2007. Se utilizó un cuestionario estructurado elaborado a partir de las Guías Complementarias para Encuestar y Evaluar Prácticas de Evaluación Ética, desarrolladas por la Organización Mundial de la Salud (2002). Los hallazgos revelan la complejidad de la situación actual de los CEI en República Dominicana y la necesidad de aunar esfuerzos para lograr un mayor cumplimiento con las recomendaciones de las Pautas CIOMS.

The aim of this study is to describe the situation of scientific ethical review committees in Dominican Republic, in terms both their organization, composition, activities and training needs, and the level of following recommendations offered by International Ethical Guidelines for Biomedical Research involving Human Beings (2002). Seven scientific ethical review committees reporting activities during 2007 were included. A structure questionnaire elaborated based on "Complementary Guidelines to Survey and Evaluate Ethical Review Practices" developed by World Health Organization (2002) was used. Findings reveal the complexity of current situation of ethical review committees in Dominican Republic and the need to join efforts to achieve greater fulfillment of CIOMS guidelines recommendations.

O objetivo deste estudo é descrever a situação dos comitês de ética em pesquisa (CEI) da República Dominicana, em termos tanto de sua organização, composição, atividades e necessidades de capacitação, como do nível em que seguem as recomendações oferecidas pelas Pautas Éticas Internacionais para a Pesquisa Biomédica em Seres Humanos (2002). Foram incluidas os sete CEI que informaram atividades durante 2007. Foi utilizado um questionário estruturado elaborado a partir das "Guias Complementares para Questionar e Avaliar Práticas de Avaliação Ética", desenvolvidas pela Organização Mundial de Saúde (2002). Os achados revelam a complexidade da situação atual dos CEI na República Dominicana e a necessidade de juntar esforços para obter um maior cumprimento das recomendações das Pautas CIOMS.